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Cost-effectiveness of on-demand rFVIIa vs prophylactic emicizumab in hemophilia a with inhibitors: clinical, QoL, and ICER-based field insights
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Abstract<sec> <title>Objective

To evaluate the cost-effectiveness of emicizumab compared to recombinant activated factor VII (rFVIIa) in Iraqi patients with hemophilia A and inhibitors.

Method

A retrospective cost-effectiveness analysis was conducted on 46 male patients with hemophilia A and inhibitors treated at a public children’s hospital in Baghdad. Data collection was conducted between November 2024 and March 2025. Clinical and economic data were retrospectively collected for a 12-month follow-up for each of rFVIIa and then emicizumab, including bleeding episodes, emergency visits, treatment costs, and health-related quality of life assessed via EQ-5D-5L (adults) and EQ-5D-Y-3 L proxy (children). Quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios were calculated.

Results

Emicizumab improved mean utility scores from 0.10 to 1.00 in children and from 0.32 to 0.89 in adults, corresponding to an incremental cost of –$2726.36 and –$4304.78 per QALY, respectively (indicating cost savings). Annual bleeding episodes dropped from 8.70 to 0, saving $282.04 per episode. Hospitalization costs decreased significantly, resulting in a total saving of $286650.41 per hospitalization prevented. Use of emicizumab also reduced overall healthcare resource utilization, eliminating emergency department visits, and minimizing diagnostic procedures.

Conclusion

Emicizumab delivers substantial clinical and economic benefits over rFVIIa. Its capacity to enhance quality of life while reducing treatment costs positions it as a cost-effective option for adults and children with hemophilia A and inhibitors in resource-constrained settings. Health authorities should prioritize emicizumab over rFVIIa for patients with hemophilia A and inhibitors, due to its superior efficacy and cost-effectiveness.

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Publication Date
Fri Dec 06 2019
Journal Name
Karbala International Journal Of Modern Science
Stereo Photogrammetry vs Computed Tomography for 3D Medical Measurements
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Publication Date
Sun Apr 01 2018
Journal Name
Aquatic Geochemistry
The Origin and MgCl2–NaCl Variations in an Athalassic Sag Pond: Insights from Chemical and Isotopic Data
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Publication Date
Wed Sep 27 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Assessing the reliability of serum macrophage migration inhibitory factor as a marker for diabetic nephropathy prediction in type 2 diabetes patients and the effect of ACE inhibitors on its level
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Abstract Diabetic nephropathy (DN) is a prevalent chronic microvascular diabetic complication. As inflammation plays a vital role in the development and progress of DN the macrophages migration inhibitory factor (MIF), a proinflammatory multifunctional cytokine approved to play a critical function in inflammatory responses in various pathologic situations like DN. This study aimed To assess serum levels of MIF in a sample of Iraqi diabetic patients with nephropathy supporting its validity as a marker for predicting nephropathy in T2DM patients. In addition, to evaluate the nephroprotective effect of angiotensin-converting enzyme (ACE) inhibitors in terms of their influence on MIF levels. This is a case-control study involving ninety

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Effectiveness of Graduality, Escalation and Argumentation in Quranic Politeness Discourse “Surat Ghafir a Model” A Pragmatic Study
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Theauthor addressed politeness discourse in “Surat Ghafir”. Quran texts include many rhetorical utterances which are considered pragmatic mechanismsconcerned with finding polite discourse. examining these texts allow to determine the effectiveness degree in the discourse, and to find the effect level that leads to interaction between the speaker and the listener. Graduation is considered an effect and a mechanism of discourse escalation.
The author reached a common definition of the graduation effectiveness term, due to its importance in finding polite discourse that is constructed by lingual manifestations some of which are escalation and graduation. Escalation is a mechanism to show the level of discourse graduation, it is a mea

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Publication Date
Tue May 01 2018
Journal Name
Journal Of Physics: Conference Series
Effect of radial magnetic field on peristaltic transport of Jeffrey fluid in curved channel with heat / mass transfer
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Publication Date
Wed May 22 2024
Journal Name
Clinics And Practice
Efficacy of Non-Surgical Periodontal Therapy with Adjunctive Methylene Blue and Toluidine Blue O Mediated Photodynamic in Treatment of Periodontitis: A Randomized Clinical Trial
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Background: This study aimed to examine the efficacy of methylene blue (MB) and toluidine blue O (TBO) photodynamic therapy (PDT) as adjuncts to root surface debridement (RSD). Methods: This split-mouth, randomized, controlled clinical trial included eighteen patients, and a total of 332 sites (control = 102, MB = 124 and TBO = 106) were examined. Two sessions of PDT were completed at baseline and two weeks after RSD. Clinical parameters of bleeding on probing (BOP), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were measured pre- and post-treatment. Results: PPD and BOP reductions in sites treated by RSD with adjunctive photosensitizers (MB and TBO) were significantly higher than in control site

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Publication Date
Mon Dec 31 2018
Journal Name
Journal Of Theoretical And Applied Information Technology
Fingerprints Identification and Verification Based on Local Density Distribution with Rotation Compensation
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The fingerprints are the more utilized biometric feature for person identification and verification. The fingerprint is easy to understand compare to another existing biometric type such as voice, face. It is capable to create a very high recognition rate for human recognition. In this paper the geometric rotation transform is applied on fingerprint image to obtain a new level of features to represent the finger characteristics and to use for personal identification; the local features are used for their ability to reflect the statistical behavior of fingerprint variation at fingerprint image. The proposed fingerprint system contains three main stages, they are: (i) preprocessing, (ii) feature extraction, and (iii) matching. The preprocessi

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Publication Date
Sun May 19 2024
Journal Name
Basrah Journal Of Agricultural Sciences
Investigation on Field Performance of Plowing and Harvesting Potatoes in Southern Baghdad
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This field experiment, was conducted to investigate a comparison of two methods for harvesting potatoes: mechanical and handy when using moldboard and chisel plow for primary tillage and three different distances for planting tubers in the rows 15, 25, and 35 cm in silt clay loam soil south of Baghdad. The factorial experiment followed a randomized complete block design with three replications using L.S.D. 5 % and 1 %. Mechanical harvest recorded the best valid potato tubers at 88.78 %, marketable yield of 31.74 ton. ha-1, efficiency lifted 95.68 %, tubers damage index 28.41, speeding up the harvesting process and reducing time and effort. Handy harvest gave the least damage to potato tubers, 6.02 %, and unlifted potato tubers, 4.32 %. Howe

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Publication Date
Fri Mar 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Improving the Effectiveness of Internal Control System In Accordance with COSO Model
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        The research aims to improve the effectiveness of internal control system according to a model COSO, by identifying the availability of system components according to the model and then improve the effectiveness of each component by focusing on areas for improvement in each component, as it was addressed to a model COSO and then Maamth with the environment, the current Iraqi by introducing some improvements on the form of some mechanisms of corporate governance of the Council of Directors, and senior management, the Audit Committee, Committee appointments, especially that supplies application available in the laws and legislation, the current Iraqi, taking into consideration to make some

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Publication Date
Thu Jul 01 2021
Journal Name
Applied Thermal Engineering
Consecutive charging and discharging of a PCM-based plate heat exchanger with zigzag configuration
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